ObamaCare: Repeal, Replace, Rinse, Repeat

If straight out repeal is a non-starter, there are two more profitable veins to mine for bringing down ObamaCare. The first attack will be in the courts, led apparently by state attorneys general, who are suing in federal court over the individual mandate for almost every American to purchase insurance. But even if successful, there are workarounds for the Democrats that would keep ObamaCare in business.

If the Democrats had used the "deem and pass" strategy in the House, a challenge could have been made to the entire bill. But realistically, even if most legal challenges were successful -- a very doubtful proposition given the history of the Supreme Court -- great swaths of ObamaCare will still be on the books, wreaking havoc.

How then to proceed? It is a sad fact that repeal of ObamaCare will be a long, laborious process that is going to take at least two and perhaps three election cycles to achieve. The Republicans must win the kinds of majorities enjoyed today by the Democrats at the ballot box, while electing a president willing to sign a repeal measure in 2012. That's a tall order. And simply running on a platform of straight repeal may not turn the trick. By 2014, the aforementioned ObamaCare constituencies will be stubbornly entrenched with millions of people benefiting from some of its provisions.

It will be a delicate operation -- requiring a scalpel, not a meat cleaver -- to repeal ObamaCare. Representative Paul Ryan has what will probably be the Republicans' ultimate strategy going into the 2010 midterms and beyond:

"Obviously we’re not for keeping this law,” he continued. “We should repeal it and replace it with reform … but not just to go back to the status quo that we knew yesterday. That wasn’t sustainable, either. We’ve been saying all along we want to fix what’s broken in healthcare without breaking what’s working in healthcare. So repeal and replace it with something better."

Still to be determined is what constitutes "something better." From what we know of previously introduced GOP-sponsored health care legislation, the kind of "reform" that Ryan is thinking about would deal with those who have chronic conditions and are unable to purchase affordable health insurance, as well as a large portion of the uninsured being covered. There would almost certainly be Medicare reform as well.

The virtue of this approach is that you co-opt the opposition of a large number of ObamaCare beneficiaries by not taking away their coverage, while tossing most of the government health care monstrosity into the dustbin of history. "Repeal and replace" would be more attractive, at least as a political strategy, than outright repeal. And given the long-term nature of the battle ahead, it might be the only viable road to follow.

But all of this might be a chimera, a fantasy born of desperation. The legal challenges may very well fail. There is the possibility that ObamaCare will become more popular than is presently contemplated and that a call for repeal will not resonate with the electorate the way it does today. There is a chance that Obama will be reelected, and that by 2016, the political landscape will have shifted dramatically away from repeal.

There are many electoral and legal scenarios that would give the GOP a partial victory in getting rid of some of the beast, but leave most of it intact. That's why I have a rather sad and morbid prediction:

In five years, the GOP will have embraced ObamaCare and be running on a platform that boasts how much more efficiently they can manage it.